U.S. health-care & coverage snapshot (2025)
Total health spending: The U.S. spent $4.8 trillion in 2023 (17.3% of GDP); CMS projects spending will continue to grow through 2032.
Uninsured rate: The share of Americans without coverage fell to 7.2% in 2023 (a record low in Census data).
ACA Marketplace momentum: ~21.7 million people selected plans during 2025 Open Enrollment—the highest on record.
Method note: Company “customer base” below refers to the most recent 2025 disclosures of medical members/lives/customers from company filings, earning releases, or official fact sheets. “Review highlights” cite national studies (J.D. Power, Insure.com) where applicable; regional rankings vary.
1) UnitedHealth Group (UnitedHealthcare)
Customer base: “Over 50 million people served” across medical benefits (Q1–Q2 2025 company reporting).
Specialty: Broad national scale across employer, Medicare Advantage & Part D, Medicaid, and individual; strong care management and analytics via Optum.
Review highlights: Frequently top-rated nationally for overall satisfaction in consumer rankings (e.g., tied #1 at Insure.com 2025); regional J.D. Power results vary by state/plan.
Key person: Stephen J. Hemsley, Executive Chair and (as of 2025) listed as CEO on UnitedHealth’s leadership page.
2) Elevance Health (Anthem-branded BCBS plans)
Customer base: ~45.6 million medical members (Q2 2025).
Specialty: Blue Cross Blue Shield coverage in 14 states; strong commercial group, Medicaid, and Medicare portfolios, plus Carelon services.
Review highlights: Consistently competitive satisfaction scores; many BCBS plans perform well in NCQA/J.D. Power at a regional level (scores vary by state).
Key person: Gail K. Boudreaux, President & CEO.
3) CVS Health (Aetna)
Customer base: ~27.1 million medical members (Q2 2025).
Specialty: Integrated pharmacy + insurance platform; Medicare Advantage rebound in 2025; strong PBM and retail ecosystem. CVS announced it will exit ACA individual exchanges in 2026.
Review highlights: Aetna often earns high marks for digital experience and provider access in national consumer surveys; results differ by region.
Key person: David Joyner (named CEO in 2025 coverage of CVS results and leadership changes).
4) The Cigna Group (Cigna Healthcare)
Customer base: ~19.8 million medical customers (Q2 2025).
Specialty: Large ASO/self-funded employer footprint; focus on specialty pharmacy, behavioral, and global benefits.
Review highlights: Often recognized for customer service and employer solutions in national rankings.
Key person: David M. Cordani, Chairman & CEO.
5) Humana
Customer base: Primarily Medicare Advantage (~5.8–5.9 million lives Q2 2025); guidance for 2025 indicates a net MA decline up to ~500,000 members vs. 2024, but financial outlook improved in Q2 2025.
Specialty: A MA-focused insurer with expanding CenterWell senior-focused primary care and home health.
Review highlights: MA star ratings and benefits mix are closely watched; 2025 adjustments stabilized results.
Key person: Jim Rechtin, President & CEO (2024–).
6) Centene
Customer base: ~27 million managed care members historically; 2025 filings emphasize leadership and Medicaid/Marketplace scale (see Q2 2025 deck).
Specialty: The largest Medicaid managed care organization and a major Marketplace (ACA) carrier via Ambetter; strong Medicare PDP presence.
Review highlights: Performance varies by state program; known for affordability on Exchange plans and breadth in Medicaid.
Key person: Sarah M. London, CEO.
7) Health Care Service Corporation (HCSC)
Customer base: Serves >26 million people across BCBS Illinois, Texas, Oklahoma, New Mexico, and Montana (company/Chicago Fed profiles).
Specialty: Blue Cross Blue Shield plans in five states; substantial ASO employer business, Medicaid, and Medicare growth; owns part of Prime Therapeutics.
Review highlights: Many HCSC BCBS plans receive strong regional member satisfaction and network breadth marks.
Key person: Maurice Smith, Chairman, President & CEO.
8) Molina Healthcare
Customer base: ~5.4–5.5 million members (June 30, 2025).
Specialty: Focused on Medicaid (including expansions) and Medicare, with Marketplace offerings in select states.
Review highlights: Known for price-competitive Medicaid options and growing Marketplace footprint; member experience varies by state.
Key person: Joseph M. Zubretsky, President & CEO.
9) Kaiser Permanente (Kaiser Foundation Health Plan)
Customer base: ~13.0–13.1 million health-plan members as of 2024–Q2 2025.
Specialty: Integrated, non-profit system (health plan + hospitals + Permanente Medical Groups) with strong value-based care model.
Review highlights: Frequently top in member satisfaction nationally (Insure.com 2025) and earns high quality marks; note recent California DMHC fine regarding grievance timeliness.
Key person: Greg A. Adams, Chair & CEO.
10) Highmark Health (Highmark BCBS / Highmark Inc.)
Customer base: ~7.1 million health-plan members (2025 fact sheet).
Specialty: Regional Blue Cross Blue Shield insurer across PA/WV/DE with integrated delivery (Allegheny Health Network).
Review highlights: Strong regional presence and integration with AHN; ratings vary by state.
Key person: David L. Holmberg, President & CEO (per 2025 fact sheet).
How to choose among the leaders (quick checklist)
Your doctors & hospitals: Start with network fit—confirm your PCP/specialists and preferred hospitals are in-network.
Total cost, not just premium: Compare premium + deductible + copays + Rx tiers.
Your program type:
Medicare eligible? Compare MA vs. Medigap + Part D; check Star Ratings and in-network providers.
Lower income or kids? Check Medicaid/CHIP eligibility & plan quality in your state.
Self-employed? Review ACA Marketplace options; 2025 enrollment is at a record high.
Service quality: Look up your plan’s J.D. Power region score and NCQA rating, and read recent state regulator actions.
